กฎหมายสุขภาพจิต
การประเมิน การกักตัว และการรักษาบุคคลที่มีความผิดปกติทางจิตตาม พ.ร.บ.สุขภาพจิต 1983
บทนำ
Mental health law in England & Wales is primarily governed by the Mental Health Act 1983 (as amended by the Mental Health Act 2007) and the Mental Capacity Act 2005. The MHA provides a legal framework for the compulsory admission and treatment of people with mental disorders in the interests of their health, safety, or for the protection of others. It balances patient autonomy against the need for intervention, with safeguards including Mental Health Tribunals, Second Opinion Appointed Doctors (SOADs), and the role of Approved Mental Health Professionals (AMHPs). The Care Quality Commission oversees the operation of the Act.
In Brief
Compulsory detention under the Mental Health Act 1983 requires application by an Approved Mental Health Professional (AMHP) supported by two medical recommendations (one s.12 approved). Section 2 is for assessment (up to 28 days); s.3 for treatment (up to 6 months, renewable). Detained patients retain rights to a Mental Health Tribunal review, an Independent Mental Health Advocate (IMHA), and free legal advice. The Mental Capacity Act 2005 governs treatment decisions for those who lack capacity.
หลักการพื้นฐาน
Sectioning — Compulsory admission under sections 2 (assessment, up to 28 days), 3 (treatment, up to 6 months), and 4 (emergency, 72 hours).
Nearest Relative — The patient's nearest relative has specific powers including the right to discharge and to be consulted before certain detentions.
Mental Health Tribunals — Independent panels that review detention and can order discharge; patients have the right to apply.
Community Treatment Orders (CTOs) — Allow supervised treatment in the community for patients who have been detained, with conditions attached.
Capacity and Consent — The Mental Capacity Act 2005 governs decisions for those who lack capacity; best interests principle applies.
Deprivation of Liberty Safeguards (DoLS) — Authorisation required for depriving liberty of incapacitated persons in hospitals or care homes.
Independent Mental Health Advocates (IMHAs) — Statutory advocacy service for detained patients.
Approved Mental Health Professionals (AMHPs) — Specially trained professionals who coordinate assessments and applications for admission.
กฎหมายสำคัญ
Mental Health Act 1983
Mental Health Act 2007
Mental Capacity Act 2005
คดีชี้นำ
Winterwerp v Netherlands
(1979) 2 EHRR 387
HL v United Kingdom
(2004) 40 EHRR 32
R (MN) v Mental Health Review Tribunal
[2008] EWHC 3383 (Admin)
สถานการณ์ทั่วไป
Being sectioned under the Mental Health Act
An AMHP, together with two doctors (one approved under s.12), can apply for compulsory admission. Patients can appeal to a Mental Health Tribunal and have access to an IMHA.
Challenging a Community Treatment Order
A patient on a CTO can apply to the Tribunal for discharge. The responsible clinician must show the criteria for the CTO are still met.
Related Careers
Frequently Asked Questions
What does it mean to be 'sectioned' under the Mental Health Act?
Being 'sectioned' means being compulsorily admitted to hospital under the Mental Health Act 1983. Section 2 allows admission for assessment for up to 28 days. Section 3 allows admission for treatment for up to 6 months (renewable). Both require an application by an Approved Mental Health Professional supported by two medical recommendations. The patient has rights to information about their detention, access to an IMHA, and to apply to a Mental Health Tribunal for discharge.
Can I refuse treatment for a mental health condition?
A patient with mental capacity can refuse voluntary psychiatric treatment. A detained patient can also refuse certain treatments — consent is required for treatments not covered by Part IV of the MHA 1983. However, detained patients can be treated for their mental disorder without consent in certain circumstances (e.g. under s.58 with a SOAD certificate for medication after 3 months). Physical treatment requires separate capacity assessment under the MCA 2005.
What are Deprivation of Liberty Safeguards (DoLS)?
DoLS (under the Mental Capacity Act 2005, Schedule A1) authorise the deprivation of liberty of a person without capacity in a hospital or care home where it is necessary and in their best interests. Authorisation is granted by the Supervisory Body (local authority or NHS). DoLS are due to be replaced by the Liberty Protection Safeguards (LPS), though implementation has been delayed. Challenges can be made to the Court of Protection.
What is a community treatment order and how does it work?
A Community Treatment Order (CTO) allows a patient who has been detained under s.3 MHA 1983 to live in the community subject to conditions (e.g. attending appointments, residing at a specified address, accepting medication). If the patient breaches conditions or their mental state deteriorates, they can be recalled to hospital. CTOs can last for 6 months, renewable. The patient can apply to the Mental Health Tribunal for discharge.
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